Healthcare Provider Details

I. General information

NPI: 1992628796
Provider Name (Legal Business Name): THERESA ANN SALINAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 W 15TH ST
DEER PARK NY
11729-4001
US

IV. Provider business mailing address

25 W 15TH ST
DEER PARK NY
11729-4001
US

V. Phone/Fax

Practice location:
  • Phone: 631-633-6748
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: